NCT03071393

Brief Summary

This study will examine if acute intermittent hypoxia (brief episodes of breathing lower oxygen), which has been shown to enhance plasticity and motor output, can enhance functional outcomes and muscle activation in individuals with spinal cord injury. Our aim is to assess breathing, sitting, standing and walking functional ability before and after acute intermittent hypoxia, compared to a sham treatment. This information may be useful in advancing rehabilitation for people with spinal cord injuries.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
17

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Jul 2017

Typical duration for not_applicable

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 20, 2017

Completed
14 days until next milestone

First Posted

Study publicly available on registry

March 6, 2017

Completed
4 months until next milestone

Study Start

First participant enrolled

July 10, 2017

Completed
3.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2020

Completed
3.2 years until next milestone

Results Posted

Study results publicly available

November 18, 2023

Completed
Last Updated

November 18, 2023

Status Verified

December 1, 2021

Enrollment Period

3.1 years

First QC Date

February 20, 2017

Results QC Date

December 5, 2021

Last Update Submit

October 27, 2023

Conditions

Keywords

acute intermittent hypoxiabreathingspinal cord injurymotor function

Outcome Measures

Primary Outcomes (4)

  • Change in Maximal Inspiratory Pressure

    An assessment of inspiratory muscle strength.

    Change between baseline and 30 minutes post-intermittent hypoxia or sham.

  • Change in Maximal Expiratory Pressure

    An assessment of expiratory muscle strength.

    Change between baseline and 30 minutes post-intermittent hypoxia or sham.

  • Change in Forced Vital Capacity

    An assessment of how much air a person can forcefully exhale after a maximal inspiratory effort.

    Change between baseline and 30 minutes post-intermittent hypoxia or sham.

  • Change in Mouth Occlusion Pressure (P0.1)

    An assessment of the pressure generated in the first 0.1 seconds of the participant's initiation of inhalation.

    Change between baseline and 30 minutes post-intermittent hypoxia or sham.

Study Arms (2)

Acute Intermittent Hypoxia, then Sham Intermittent Hypoxia

EXPERIMENTAL

Subjects with chronic spinal cord injury first received an acute intermittent hypoxia protocol with low oxygen air (9-15% inspired oxygen). After a washout period of at least one week, they then received sham intermittent hypoxia with normal oxygen air (21% inspired oxygen).

Device: Hypoxia via Hypoxico Hyp-123Device: Sham via Hypoxico Hyp-123

Sham Intermittent Hypoxia, then Acute Intermittent Hypoxia

EXPERIMENTAL

Subjects with chronic spinal cord injury first received a sham (placebo) intermittent hypoxia protocol with normal oxygen air (21% inspired oxygen). After a washout period of at least one week, they then received an acute intermittent hypoxia protocol with low oxygen air (9-15% inspired oxygen).

Device: Hypoxia via Hypoxico Hyp-123Device: Sham via Hypoxico Hyp-123

Interventions

During acute intermittent hypoxia, subjects will undergo 15 brief exposures (60-120 seconds) of low oxygen air (9-15% inspired oxygen) delivered by an air generator, alternated with 15 brief exposures (60-120 seconds) of ambient room air.

Also known as: Altitude Generator
Acute Intermittent Hypoxia, then Sham Intermittent HypoxiaSham Intermittent Hypoxia, then Acute Intermittent Hypoxia

During sham intermittent hypoxia, subjects will undergo 15 brief exposures (60-120 seconds) of normal oxygen air (21% inspired oxygen) delivered by an air generator, alternated with 15 brief exposures (60-120 seconds) of ambient room air.

Also known as: Altitude Generator
Acute Intermittent Hypoxia, then Sham Intermittent HypoxiaSham Intermittent Hypoxia, then Acute Intermittent Hypoxia

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Male or female, ages 18-65
  • Greater than 6 months post-spinal cord injury
  • Spinal cord injury affecting segments between C4-T12
  • No other known neurological disorders
  • Able to provide informed consent
  • no severe musculoskeletal impairments, open wounds, or skin lesions that would limit participation in functional assessments.

You may not qualify if:

  • Presence of a self-reported uncontrolled medical condition including, but not limited to: cardiovascular disease; sleep apnea; obstructive lung disease; severe neuropathic or chronic pain; severe recurrent autonomic dysreflexia
  • Severe, untreated bladder or urinary tract infection
  • Presence of severe musculoskeletal impairments, open wounds, or skin lesions that would limit participation in functional assessments
  • Women who report being pregnant or test positive on a pregnancy test

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

University of Florida

Gainesville, Florida, 32611, United States

Location

Brooks Rehabilitation

Jacksonville, Florida, 32216, United States

Location

Related Publications (6)

  • Gonzalez-Rothi EJ, Lee KZ, Dale EA, Reier PJ, Mitchell GS, Fuller DD. Intermittent hypoxia and neurorehabilitation. J Appl Physiol (1985). 2015 Dec 15;119(12):1455-65. doi: 10.1152/japplphysiol.00235.2015. Epub 2015 May 21.

    PMID: 25997947BACKGROUND
  • Hayes HB, Jayaraman A, Herrmann M, Mitchell GS, Rymer WZ, Trumbower RD. Daily intermittent hypoxia enhances walking after chronic spinal cord injury: a randomized trial. Neurology. 2014 Jan 14;82(2):104-13. doi: 10.1212/01.WNL.0000437416.34298.43. Epub 2013 Nov 27.

    PMID: 24285617BACKGROUND
  • Trumbower RD, Jayaraman A, Mitchell GS, Rymer WZ. Exposure to acute intermittent hypoxia augments somatic motor function in humans with incomplete spinal cord injury. Neurorehabil Neural Repair. 2012 Feb;26(2):163-72. doi: 10.1177/1545968311412055. Epub 2011 Aug 5.

    PMID: 21821826BACKGROUND
  • Tester NJ, Fuller DD, Fromm JS, Spiess MR, Behrman AL, Mateika JH. Long-term facilitation of ventilation in humans with chronic spinal cord injury. Am J Respir Crit Care Med. 2014 Jan 1;189(1):57-65. doi: 10.1164/rccm.201305-0848OC.

    PMID: 24224903BACKGROUND
  • Satriotomo I, Nichols NL, Dale EA, Emery AT, Dahlberg JM, Mitchell GS. Repetitive acute intermittent hypoxia increases growth/neurotrophic factor expression in non-respiratory motor neurons. Neuroscience. 2016 May 13;322:479-88. doi: 10.1016/j.neuroscience.2016.02.060. Epub 2016 Mar 2.

    PMID: 26944605BACKGROUND
  • Sutor T, Cavka K, Vose AK, Welch JF, Davenport P, Fuller DD, Mitchell GS, Fox EJ. Single-session effects of acute intermittent hypoxia on breathing function after human spinal cord injury. Exp Neurol. 2021 Aug;342:113735. doi: 10.1016/j.expneurol.2021.113735. Epub 2021 May 2.

MeSH Terms

Conditions

Spinal Cord InjuriesRespiratory Aspiration

Condition Hierarchy (Ancestors)

Spinal Cord DiseasesCentral Nervous System DiseasesNervous System DiseasesTrauma, Nervous SystemWounds and InjuriesRespiration DisordersRespiratory Tract DiseasesPathologic ProcessesPathological Conditions, Signs and Symptoms

Results Point of Contact

Title
Emily Fox, Principal Investigator
Organization
University of Florida

Study Officials

  • Emily J Fox, MHS, DPT, PhD

    University of Florida

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Masking Details
Subjects will be asked to participate in two visits at least 7 days apart. Subjects will be assessed on various clinical outcomes before and after an exposure to one of two treatments. In one visit, subjects will be assessed before and after acute intermittent hypoxia, consisting of brief exposures of breathing low oxygen air, alternated with brief exposures to room air. In the other visit, subjects will be assessed before and after an exposure to a sham treatment, consisting of breathing brief exposures of normal oxygen air, alternated with brief exposures to room air. Subjects will undergo acute intermittent hypoxia or a sham treatment in a randomized order.
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 20, 2017

First Posted

March 6, 2017

Study Start

July 10, 2017

Primary Completion

September 1, 2020

Study Completion

September 1, 2020

Last Updated

November 18, 2023

Results First Posted

November 18, 2023

Record last verified: 2021-12

Data Sharing

IPD Sharing
Will not share

Locations